Patterns of Injury at Two University Teaching Hospitals in Rwanda: Baseline Injury Epidemiology Using the Rwanda Injury Registry

Introduction: Globally; more worldwide deaths in 2010 could be attributed to injuries than the total number of deaths from infection with AIDS; tuberculosis; and malaria combined; with a disproportionate number of these deaths occurring in low- and middle-income countries. Yet; worldwide research and plans for prevention of injuries are far below other world health problems; especially in developing countries. Methods: A 31-item; 2-page registry form was adapted from regional trauma registries for use in Rwanda to collect data at the two main university referral hospitals in Kigali and Butare. Beginning in 2011; registrars recorded demographics; pre-hospital care; initial physiology; early interventions; and disposition of injured patients who met our selection criteria. Inpatient 30-day discharge status; mortality; and complications were abstracted from patient charts; ward reports and operating room logs. Descriptive analysis was used to evaluate patterns of injury and basic injury epidemiology at the two study hospitals from August 1; 2011-January 31; 2013. Results: A total of 3599 patients were registered from August 1; 2011 to January 31; 2013. Patients were predominantly male; and road traffic crashes were the leading cause of injury overall; contributing to a greater proportion of injuries in the more urban capital than the smaller city of Butare. The majority of patients were admitted to the hospital. All variables evaluated except for the percentage of injuries acquired via a penetrating mechanism showed statistically signifiant differences at an alpha signifiance level of 0.05; illustrating that the trauma population presenting at the two hospitals may be quite different. Conclusion: The Rwanda Injury Registry indicates a high burden of road traffic injuries in a predominantly working age male population over an eighteen-month period. This information can be useful in expanding injury surveillance programs and hopefully implementing population-based prevention programs

Repeatability of Manual Coding Of Cancer Reports in the South African National Cancer Registry; 2010

"Data validity is a very important aspect of cancer registries in ensuring data quality for research and interventions. This study focused on evaluating the repeatability of manual coding of cancer reports in the South African National Cancer Registry (NCR). This cross-sectional study used the Delphi technique to classify 48 generic tumour sites into sites that would be most likely (""difficult"") and least likely (""not difficult"") to give rise to discordant results among coders. Reports received from the Charlotte Maxeke Academic Hospital were manually recoded by five coders (2 301 reports; e.g. approximately 400 reports each) for intracoder agreement; and by four coders (400 reports) for inter-coder agreement. Unweighted kappa statistics were calculated and interpreted using Byrts' criteria. After four rounds of the Delphi technique; consensus was reached on the classification of 91.7 (44/48) of the sites. The remaining four sites were classified according to modal expert opinion. The overall kappa was higher for intra-coder agreement (0.92) than for inter-coder agreement (0.89). ""Not difficult"" tumour sites reflected better agreement than ""difficult"" tumour sites. Ten sites (skin other; basal cell carcinoma of the skin; connective tissue; other specified; lung; colorectal; prostate; oesophagus; naso-oropharynx and primary site unknown) were among the top 80 misclassified sites. The repeatability of manual coding at the NCR was rated as ""good"" according to Byrts' criteria. Misclassified sites should be prioritised for coder training and the strengthening of the quality assurance system."

Timing of Spontaneous Birth and the Risk of Adverse Perinatal Outcome

Abstract:The study aspired to assess the impact of time of birth on spontaneous onset of labour and delivery. A retrospective descriptive study was conducted from the Empangeni Hospital delivery registry on 9;397 infant births between January to December 2005; weighing more than 1;000 g. Logistic regression; adjusting for birth weight and for gender was used to estimate the relationship between spontaneous birth and timing of birth. A higher proportion of births (59) occurred between 10h00 and 22h00 of the day. Estimating the hourly births; we found that the daytime peak is 5.3 and occurred at 10h00 while the night-time peak is 4.9 and occurred at 20h00. Maternal age was significantly associated with the timing of spontaneous births (p 0.05). A higher proportion of preterm babies was born during the day (6.4) and early night (3.4) compared to late night births (1.6). There were significant differences between multiple births and low birth weight infants born during the day (1.1; 6.9) and night (0.8; 6.3). However; low birth weight babies were born mostly during early night rather than late night (4 vs. 2.3; p 0.05). Adverse pregnancy outcome; measured by estimating the perinatal mortality rate; was the same for day and night and was equally distributed between early and late night. Timing of birth of infants did not influence the negative outcomes of pregnancy among this study population

Cancer in Nigeria: a 10-year analysis of the Kano Cancer registry

Background: Cancer is a major health problem in developed countries and epidemiological evidence shows the emergence of a similar tend in developing countries; particularly in sub-Saharan Africa where HIV/AIDS is predicted to augment the cancer burden. The present study analyses the profile of cancers recorded in the first decade (1995-2004) of establishment of the Kano cancer registry (KCR) a histology/ cytology-based registry in Kano; Nigeria. Methods: Records of cancer cases diagnosed based on histology or cytology and entered into the registry were retrieved and categorized by type/ organ sites affected according to International Classification of Diseases for Oncology.Results: There was a steady rise in frequency of cancer over the period where a total of 1990 cancer cases were recorded comprising of 1001 (50.3) males and 989 (49.7) females. Cancers of the cervix (22.9); Breast (18.9); Ovary (8.2); non-melanoma skin cancer (6.3); and Uterus (6.2) were the most frequent female cancers. In males; cancer of the prostate (16.5); bladder (10.2); non-melanoma skin (9.9); colorectum (9.3) and connective tissue (6.3) were most common.Burkits lymphoma (31.4); other lymphoreticular cancers (23.8) and retinoblastoma (20) predominated in children. Conclusion: The KCR supports existing predictions of an increase in incidence of cancers in developing countries. There is need for establishment of comprehensive cancer control programmes in developing countries for the common cancers of the cervix; breast; prostate; bladder; skin and colorectum which are amenable to prevention; early detection and cure

Comparative study of superficial cancer in Tanzania

Examination of the Tanzania Cancer Registry from 1978 to 1988 showed squamous cell carcinomas to be the most frequent form of superficial malignancy; followed by Kaposi's sarcoma and then malignant melanoma. Males were more afflicted than females; and the lower limbs were predominant sites of the lesion. In terms of relative importance of various types of superficial cancers; the pattern seen in Tanzania was similar to that in another East African country. In a West African country; Kaposi's sarcoma was not common. On the other hand; among blacks in the USA; basal cell carcinomas were almost similar in frequency to squamous cell carcinomas